Analysis of diversity and drug susceptibility profiles of yeast isolates and their biofilm production characteristics among HIV and AIDS patients presenting with TB

Author(s): N.B.Okelo, J.K.Toure

Although several fungal organisms are known to infect HIV and AIDS patients, the diversity of yeast pathogens that infect individuals in Kenya is not known. In the present study sputumsampleswere collected fromHIV positive patients who presented at the hospital with TB. The yeasts organisms were isolated using Potato DextroseAgar and identified by germtube test, CHROMagar and Urease based agar. The production of biofilm was tested using the microtitre plate method. The activity of Amphotericin B, Fluconazole and Ketaconazole was tested using the standard disc diffusion method. Out of the 91 patients, 53 (58%) were females. Thirty seven patients (41%) were aged between the ages 26 and 45 years old. The most common isolateswere Cryptococcus neoformans (28%), followed byCndida parapsilopsis (19%), C. krusei (16%), C. albicans (15%) and C. tropicalis (13%). The different species showed high levels of drug resistance to fluconazole (74.0%), ketaconazole (74.0%) and amphotericin B (33.7%). Biofilm production was observed in 28% of all the isolates and was not associated with drug resistance (p>0.01). This study shows that the lungs of HIV patients with TB are often colonized by opportunistic yeasts such as Cryptococcus and Candida spp. The most common isolates included Cryptococcus neoformans, Candida parapsiliosis, Candida krusei and Candida albicans, and amphotericin B was the most active drug against these organisms. Further studies are needed to determine the potential impact of these organisms on the emergence ofmulti-drug resistant (MDR) and extensively drug resistant tuberculosis (XDR TB).

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